Moody's Investors Service affirmed its "A1" rating for Davenport, Iowa-based Genesis Health System, affecting $142.7 million of outstanding revenue bonds.
The rating reflects the likelihood that the system's margins will remain modest in fiscal year 2019 due to continued cost and reimbursement pressures. However, Genesis Health System has a growing lead market share in its primary service area, and its balance sheet metrics are adequate.
The rating outlook has been revised from stable to negative.